The practice of medicine has greatly advanced as evidenced by patients being treated with previously incurable diseases, such as cancer. One reason, among many, for the advancement of medicine is a result of improvement of medical imaging technology. Medical images may include many different types of images of the human body, including radiological images, CAT scan images, endoscopic images, magnetic resonance images, etc. Through the use of medical imaging technology, medical professionals are able to see images of internal organs, for example, of patients to help diagnose medical conditions of the patients. Medical imaging allows for diseases, such as breast cancer, to be diagnosed in early stages, which greatly improves chances of recovery. While medical imaging technology has significantly improved medical care, because of the nature of creating and interpreting medical images, radiological or other imaging techniques, inaccuracies in the imaging and interpretation processes of the medical images may result. Because of the inaccuracies in the imaging and interpretation processes, patient medical conditions are often misdiagnosed.
Misdiagnosis of a medical condition, such as a disease, may come in the form of false positives, false negatives, and equivocal diagnoses. A false positive is a detection of a disease that does not exist. A false negative is a failure to detect a disease that is present in a patient. An equivocal diagnosis is a statement that a definitive diagnosis cannot be made based on the information available (e.g., “cancer cannot be ruled out”). Each of these misdiagnoses results in higher costs of treatment, additional suffering to patients, and additional burden on the healthcare system as a whole. It has been estimated that frequency of misdiagnosis of radiological imaging interpretations is as high as 30%. And, given that it has been estimated that 40% to 60% of total healthcare spend is influenced by radiological imaging and interpretations therefrom, misdiagnoses results from misinterpretation of medical imaging has a large impact on the healthcare system.
An example of the effects of a misdiagnosis is as follows. A medical image reading professional identifies a spot on a lung. The lung spot may be any of a number of different medical conditions, including a benign solitary pulmonary nodule, small cell lung carcinoma, non-small cell lung carcinoma, or any number of other medical conditions. If the medical image reading professional determines that the lung spot is a benign solitary pulmonary nodule, but also denotes that “cancer cannot be ruled out,” a treating medical professional is compelled to perform additional testing, a biopsy of the lung spot, and possibly surgery to remove the lung spot to avoid a malpractice claim. The cost for each of these additional diagnostic treatments can be very high from financial, patient anxiety and pain, and medical system resource perspectives. If it turns out that after the additional diagnostic treatments that the patient had a benign, solitary pulmonary nodule that could have been identified by the medical image reading professional at the initial medial image reading, all of the additional diagnostic treatments would have been avoided.
Although medical professionals are considered to be highly regarded, and justifiably so in most cases, medical professionals are not all trained in the same manner or have the same level of proficiency as one another. As in all professions, some medical professionals may have better education, training, or any other differentiator than other medical professionals. For example, one medical image reading professional may have better eyesight or cognitive reasoning skills than another and, therefore, be better at determining a correct or more accurate diagnosis than another with worse eyesight or cognitive reasoning skills.
Medical image reading professionals are affiliated with medical facilities, such as hospitals, clinics, medical offices, imaging centers, or other medical facilities. As understood in the art, medical insurance companies or payors contract with medical facilities to pay the medical facilities for services rendered by medical professionals at the medical facilities. For example, when a patient visits a medical facility, the patient receives services from one or more medical professionals, including medical image reading professionals. Medical image reading professionals often assist treating physicians by reading medical images and diagnosing medical conditions so that treating physicians may create treatment plans or perform additional testing. Because medical facilities are typically general in treating medical conditions and cannot afford to have a large medical image reading professional staff, each medical image reading professional tends to become generalized and read medical images of a wide variety of anatomical regions. If a treatment plan is approved by a medical insurance company that is a provider of the patient, the medical insurance company pays the medical facility or medical professionals who participated in treating the patient. One problem that exists is that, as described above, not all medical professionals, including medical image reading professionals, have the same level of proficiency and insurance companies who contract with a patient are responsible for paying medical professionals with varying degrees of proficiency. And, if a patient is diagnosed or treated incorrectly, the medical insurance company will pay more for the diagnostic procedures and treatment then if the patient was correctly diagnosed and treated.